Is it Compassion Fatigue…or Depression?

Frustrated young man sitting on the couch Feelings of sadness, lack of motivation, loss of interest – these and other symptoms of depression sound a lot like compassion fatigue, don’t they? It’s a question I often get when I present compassion fatigue workshops to animal caregivers. So what exactly is the difference between compassion fatigue and full-blown depression? The first thing to understand is that compassion fatigue, unlike depression, is not a mental illness – it’s the normal consequence of helping suffering or traumatized populations. Of course, depression can co-exist with compassion fatigue, and if left untreated, compassion fatigue can certainly turn into depression. Mental illnesses such as depression are diagnosed by therapists, psychiatrists, and other mental health professionals who use a standardized guide called the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). The DSM-5 is basically a reference manual that classifies and provides diagnostic criteria for psychiatric disorders. So let’s jump right in and talk about some similarities – and differences – between compassion fatigue and depression. You may recall that compassion fatigue is not an illness, but rather a set a symptoms that can fall on a continuum. In other words, symptoms can come and go and fluctuate as far as intensity. As an animal welfare advocate, compassion fatigue for me personally is something that is always there. Sometimes it sits quietly simmering on the back burner and other times it boils over. It’s that boiling over point that can make people vulnerable to developing more serious conditions such as depression. Types of depression According to the DSM-5, there are several variations of depression. I’m going to focus here on two common types that affect adults – major depressive disorder and persistent depressive disorder. Please note that the definitions presented here are simplified; please consult with a licensed mental health professional if you think you may be suffering from depression and especially if you are having suicidal thoughts. Major Depressive Disorder Major Depressive Disorder (MDD) is a serious and debilitating illness that, just like severe compassion fatigue, can interfere with your quality of life. In order to meet the criteria for MDD, one of the following core symptoms must be present – a depressed mood (e.g., sadness) or a loss of interest in things you once found pleasurable. In addition, at least four of the following symptoms have been present for a minimum of two weeks:
  • Considerable weight loss or decrease in appetite, or significant weight gain or increase in appetite.
  • Loss of energy or feeling fatigued on most days.
  • Insomnia (sleeping too little) or hypersomnia (sleeping too much) nearly every night.
  • Trouble concentrating or making decisions.
  • Psychomotor agitation (e.g., feeling restless, “on edge”), or psychomotor retardation (e.g., slow speech and/or movement).
  • Chronic feelings of worthlessness and/or guilt.
  • Frequent thoughts of death and dying, thoughts of suicide with or without a plan, and/or suicide attempts.
Persistent Depressive Disorder Once known as Dysthymia, Persistent Depressive Disorder or PDD is a milder, yet chronic form of depression. In order to be diagnosed with PDD, you likely have been struggling with the “blahs” for at least two years, and have had at least two of the following symptoms present on more days than not:
  • Trouble sleeping (too little or too much)
  • Loss of energy, feeling fatigued
  • Appetite disturbance (eating too much or too little)
  • Feeling hopeless
  • Difficulty concentrating or making decisions
  • Low self-esteem
Getting Help You probably recognize many overlapping symptoms between depression and compassion fatigue, and both can take a toll on your well-being. If you suspect that you may be struggling with compassion fatigue, depression, or both, it is best to seek the opinion of a professional to get the help you deserve.